• Transverse Process Fracture

    Definition

    The bones of spinal column are called vertebrae. Each vertebra has 2 wing-like protrusions, called a transverse process, that extend toward the sides. These protrusions provide an area for muscles and ligaments to attach to provide movement and flexibility in the back. Transverse process fractures can occur anywhere along the spinal column. They are more common in the back than the neck.
    A transverse process fracture is a break or crack in 1 or more of these protrusions.
    Cross Section of Spine
    heart
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    Causes

    Transverse process fractures are caused by severe trauma to the back such as:
    • Falls
    • Car, motorcycle, or pedestrian collisions
    • Severe and sudden twisting or bending
    • Severe blows to the back and spine
    • Violence, such as a gunshot

    Risk Factors

    Factors that may increase your chance of transverse process fractures include:
    • Increased age
    • Osteoporosis
    • Certain diseases or conditions that weaken bones, such as tumors or cysts
    • Decreased muscle mass
    Activities or accidents most often associated with transverse process fractures include:
    • Falls from heights, such as a ladder, bike, or horse
    • Playing certain sports that involve sudden twists and turns, or extreme contact especially without proper protective gear
    • Car or motorcycle accidents especially without use of seatbelt
    • Severe and sudden twisting or bending
    • Severe blows to the back and spine
    • Violence, such as a gunshot

    Symptoms

    Transverse process fractures may cause:
    • Severe pain that may be worse during movement
    • Tenderness, swelling, and possible bruising over the area
    • Numbness, tingling, or muscle weakness
    • Decreased range of motion around the affected area of the spine
    • Loss of bladder or bowel function

    Diagnosis

    You will be asked about your symptoms and medical history as well as any accident or activity associated with the pain. . The injured area will be examined. A complete neurological exam will be done to look for damage to the nerves.
    Imaging tests may be done to look for signs of damage to the bones and effects on the spinal cord. Tests may include:

    Treatment

    Immediate care is important. Proper treatment can prevent long-term problems. Treatment will depend on how serious the fracture is.

    Bone Support

    Some fractures cause pieces of bones to separate. These pieces will need to be put back into their proper place. This may be done:
    • Without surgery—Minor injuries can be treated with a back brace to keep the spinal column in line while it heals.
    • Surgery—Screws, rods, wires, or cages are used to reconnect bone pieces and hold them in place. Surgery may also be needed to repair vertebrae, relieve pressure on the spinal cord or nerves, or remove any damaged discs.

    Rest and Recovery

    It may take up to 6 weeks for a transverse spinal fracture to heal. Healing time varies by age and overall health. Children and people in better overall health heal faster.
    Activities will need to be adjusted while the spine heals, but complete rest is rarely required and can actually slow recovery.
    Physical therapy or rehabilitation will be used to improve range-of-motion and strengthening the spine. Do not return to activities or sports until your doctor says it is okay to do so.

    Prevention

    Fractures are most often the result of an accident. To decrease the risk or severity of accidents:
    • Avoid situations that put you at risk of physical harm.
    • Always wear a seatbelt when driving or riding in a car.
    • Do not drive under the influence of alcohol or drugs.
    • Wear proper padding and safety equipment for sports and activities.
    • Do weight-bearing exercises to build strong muscles and bones.
    To help reduce falling hazards at work and home:
    • Clean spills and slippery areas right away.
    • Remove tripping hazards such as loose cords, rugs, and clutter.
    • Use non-slip mats in the bathtub and shower.
    • Install grab bars next to the toilet and in the shower or tub.
    • Put handrails on both sides of stairways.
    • Walk only in well-lit rooms, stairs, and halls.
    • Keep flashlights on hand in case of a power outage.

    RESOURCES

    National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov

    Ortho Info—American Academy of Orthopaedic Surgeons http://orthoinfo.org

    CANADIAN RESOURCES

    Canadian Orthopaedic Foundation http://www.canorth.org

    Spinal Cord Injury Canada http://spinalcordinjurycanada.ca

    References

    Fractures of the thoracic and lumbar spine. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00368. Updated September 2015. Accessed August 30, 2017.

    Krueger MA, Green DA, et al. Overlooked spine injuries associated with lumbar transverse process fractures. Clin Orthop Related Res. 1996;327:191-195.

    Seo MR, Park SY, et al. Spinous process fractures in osteoporotic thoracolumbar vertebral fractures. Br J Radiol. 2011;84(1007):1046-1049.

    Spinal trauma—emergency management. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T908630/Spinal-trauma-emergency-management. Accessed August 30, 2017.

    Transverse process fracture. Sports Injury Clinic website. Available at: http://www.sportsinjuryclinic.net/sport-injuries/low-back-pain/transverse-process-fracture. Accessed August 30, 2017.

    Revision Information

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